The focus of addiction treatment has typically been abstinence from drugs. It is desirable to also measure constructs that in a broader sense could explain the experiences related to substance dependence, like Quality of Life (QoL) aspects. Though the studies on QoL among populations with other severe and/or chronic diseases have increased, this does not reflect the QoL research among populations with substance use disorders (SUD). International

studies show that SUD-patients have a severe lower QoL than both normal populations and populations with other severe diseases such as for example cancer.

Aims.

1) To describe perceived QoL among patients admitted to detoxification treatment, Sørladet sykehus, Addiction Unit, and to investigate change in QoL 6 months after discharge, and 2) To investigate factors associated with change of QoL.

Theoretical framework.

The QoL5 questionnaire is based on an integrative theory on generic and global Quality of Life. QoL is measured on a 5 points scale.

Methods.

The study is a naturalistic, prospective cohort study of patients admitted to detoxification treatment, and a follow-up 6 months after admission. Quality of Life was measured using QoL5; with 0.9 being the highest and 0.1 the lowest score. Substance use and other independent variables were measured using the EuropASI questionnaire and other selfVIII rating severity scales (Syraap, SCL10, M.I.N.I. 5 plus og AAAS). A mean QoL score of 0.69 has been observed in a general population sample, and cut-off for low QoL has been suggested at scores below 0.5.

Results.

At admission: The sample consisted of 140 patients (mean age 41); 32% were women. The number of years of problematic substance use was; mean 11 years (SD 9). The mean QoL5 rating in this sample was 0.43 (SD 0.15). Two-thirds of the sample scored <0.5. Preliminary analysis (regression) showed that higher perceived problem severity in the psychological, family/relationship and drug problem domains were associated with lower QoL scores at baseline. At 6 months follow-up: The follow-up sample consisted of 113 (81%) of the total sample (N=140). Total years of severe use of most used substance was associated with decrease in QoL. Participation in self help groups (AA/NA) and personal involvement in these groups was associated with increase in QoL. Abstinence from substances was also associated with a

positive change in QoL.

Conclusions:

The perceived QoL in patients admitted to detoxification treatment was severely low compared to the scores observed in a general population, and in other clinical samples. Patients living alone and patients having psychological problems had especially low QoL. Decrease in QoL 6 months after discharge from treatment was associated with increasing numbers of years in long-term substance use. Positive change in QoL was associated with abstinence from substances and involvement in self-help groups. Findings suggest that a

significant number of patients experienced severe existential problems and significant suffering. The results imply that QoL-aspects deserve more attention in treatment settings, in addition to the traditional abstinence-oriented aim. QoL measures can beneficially be integrated both into treatment as well as in future studies.